Sperm Tales: An Informative Guide through the Challenges of Infertility Reviewed By Lois C. Henderson of Bookpleasures.com

Lois C. Henderson

Reviewer Lois C. Henderson: Lois is a freelance academic editor and back-of-book indexer, who spends most of her free time compiling word search puzzles for tourism and educative purposes. Her puzzles are availableHERE and HEREHer Twitter account (@LoisCHenderson) mainly focusses on the toponymy of British place names. Please feel welcome to contact her with any feedback at LoisCourtenayHenderson@gmail.com.

Lynn M. Collins’ carefully constructed guide to infertility management not only has a catchy and intriguing title, Sperm Tales: An Informative Guide through the Challenges of Infertility, but is also highly accessible, no matter how scant your medical background. Sperm Tales is, nevertheless, extremely well informed, with Collins referencing her sources well, focusing on the professionally sound, such as the American Society for Reproductive Medicine (ASRM) and the Center for Disease Control (CDC), without drowning her audience in a plethora of unnecessary detail.

Collins’ professional expertise in the field is indubitable. As she states: “I have managed an infertility laboratory for over 12 years and have been closely involved with physicians and nurses on a day-to-day basis, as well as with the couples participating in the program.” Consequently, not only does she have the professional expertise that is required to write a book of this nature, but she also has the requisite level of compassion and empathy to reach out on a personal level to her audience, no matter their background.
The probing nature of the questions that she asks (such as: “When should I have my baby?”, “Do I need infertility counseling?”, and “What to expect – What is ART (otherwise known as Assisted Reproductive Technologies)?”) reveal that Collins is truly on top of her game. Never afraid to handle the trickier issues, Collins covers such contentious and problematic matters as fertility during cancer treatments and same sex couples and ART.

Despite the four-page index being less detailed than some would, no doubt, like, it is, nevertheless, a helpful guide to the work when combined with the contents pages, with the chapter titles clearly indicating the relevant content, such as “How To Choose A Fertility Center” and “The Initial Consult”.

The rationality and logic of Collins’ common sense approach, which is comforting and reassuring, is bound to instill a spirit of trust in the reader that is likely to make them believe what she has to say, and to follow the steps to overcoming infertility that she recommends.

Collins encourages and motivates, rather than prescribing set actions. She is intimately aware of the diversity of causes that can lead to infertility, and she discusses them thoroughly and cogently. Her one-on-one approach to the reader not only lends an air of familiarity to the message that she wishes to convey, but it also fosters a spirit of fluidity and balance in the text, so that Sperm Tales, unlike many other works on infertility, is highly readable and easily understandable. The readability of her text is enhanced still further by her good sense of humor, which is especially marked in her introduction of a character and friend, named Spanky, who is the mascot of Collins’ infertility clinic. Spanky makes timely interjections throughout the text, all sourced from the funny comments that Collins’ patients have made over the years―after all, she believes that learning should be fun. So don’t expect a dry as dust tome that puts you to sleep after the second paragraph, but one that will, at times, most likely tickle your funny bone, as well as covering your nether regions. In short, enjoy!

Let’s Talk Sperm

Firstly, a happy Chinese New Year – expect two weeks of celebrating the year of the Fire Monkey with all sorts of Chinese decorations, traditions and food.

For those of us still working at conceiving, check out my page herefor tips of TCM (Traditional Chinese Medicine). I am no practitioner, this page is just a small collection of info gathered through research and advice from my own Traditional Chinese Doctor.

For a little extra fun because it’s Chinese New Year, if you haven’t already read my post on Kate Davies’ fertility blog, then check it out herefor some traditional Chinese Folklore for increasing fertility.

So now let’s get on to the main subject of the day, which is SPERM.

Ladies like us who are trying to conceive learn very quickly about ourselves. We who are going through all sorts of fertility treatments, on a whole plethora of prescription drugs, bought out every health store’s vitamin collection, researched our way through pages and pages of internet info and swap all of this info in a number of fertility support groups, have learnt so much about our own bodies that we could go back to university to study biology, chemistry, anatomy and medicine and ace it first time!

That being said, the information on our male partners is another study altogether. Those insy winsy swimmers remain ever elusive. Info is not as thorough and many questions still remain – what can help him to increase the quantity, the quality, the speed, the volume?

He thinks he’s got off lightly, because let’s face it, all he needs to do most of the time is go on a date with a cup – wam, bam, thank you ah… Yes, well don’t let him off that easy, ladies. Those swimmers need to be taken care of too or they will fail to do the job that you have been sweating, crying, bleeding and injecting over.

So, I present to you a very knowledgeable lady, who is my guest blogger today and available to answer all your sperm related questions. Lynn Collins is a trained Andrologist (yes, I had to look up the word myself ;-)) who managed a sperm bank for over twelve years. She has washed and analysed countless swimmers, which makes her an expert in this field.

So no more from me…I am now handing you over to Lynn to provide you and your man with great information to help you on your fertility journey…

I was very excited when I was asked to write a blog on the male prospective of infertility and who better to write this than someone who has worked with men over 12 years. I always said “ I see more men in a day than any other woman.” I think Howard Stern would be interested in that statement.

I am a trained Andrologist, which means that I provide diagnostic and treatment services to men with reproductive health issues.I managed a Sperm Bank for over twelve years and performed semen analysis; sperm washed specimens for IUI’s and managed a non-donor sperm bank. I originally trained for the position at Brigham and Women’s Hospital in Boston and later took all my new knowledge and set up an infertility lab north of Boston.

So let’s review the male reproductive system :

Sperm takes 72 days to reproduce and then they are stored in the epididymis which is located on each side of the teste, where they are stored and matured. The sperm that are produced by the testes are immature and would be incapable to fertilize an egg. The mature sperm swim in semen through the woman’s cervix and up the fallopian tubes to meet the egg for fertilization.

Men need to have healthy sperm to be able to reach those eggs and to do that, men need to have a healthy lifestyle. There are many factors that can affect mens fertility from genetics, hormones, enviormental exposures and lifestyles. As time goes on with infertility studies they are showing all the time that lifestyle factors can cause damage to the DNA of the sperm. Remember one half of the DNA is from the sperm and the other is from the egg.

How can men maximize and protect one of their most valuable assets…their fertility?

Here is my advice…

1. Maintain a good weight and regular exercise. Studies have shown overweight men could have hormonal problems associated with low sperm count and quality. Much of the sexual dysfunction humans experience is related to low testosterone and lack of exercise. A dramatic drop in testosterone is followed by weight gain in men. Obesity is not only related to diabetes but also related to lower testosterone levels. Testosterone is needed for normal sperm production. Regular exercise helps reduce stress and aids in weight control and a better mind set.

2. Eat Right and take multiple vitamins. Opt for a healthy diet of fruit and vegetables and choose whole grains instead of refined carbohydrates. Men consuming omega-3 fatty acids were found to have sperm with a more normal structure and higher concentration (count) than men who consume junk food diets with high levels of saturated fats.

Ensure you are taking a multi, pantothenic acid, biotin, pyridoxine, folic acid, inositol, and vitamin B12, Vitamin C, selenium and zinc are important in a multi, too. Zinc supports good testosterone metabolism, and B-complex improves digestion, and helps with stress.

3. Stop smoking, watch alcohol and no illicit drugs:.It is common knowledge that cigarette smoking is detrimental to health. Many studies have shown that the components of the cigarette can transfer the blood- testes barrier and contribute to sperm DNA damage. Men who smoke heavily or drink and use recreational drugs appear to have lower sperm motility and a higher proportion of abnormal sperm.

4. Avoid hot baths and hot tubs and wear boxers. All that heat will kill sperm in its prime. The same is true with putting laptops on your lap. The old wives’ tale that tight underwear causes decreased fertility has some basis in the truth, as it causes heat but is not scientifically proven. However, why not do everything you can to help just in case?

Also, studies have shown that men that are avid bike riders can have a temperature effect on the sperm being in a sitting position for a long period of time, while the bouncing could cause trauma to the testes.

5. Time clock is also ticking for men: Men go through their own type of menopause like women called andropause, which is a decline in testosterone. Testosterone is a major barometer for the aging process. Starting at the age of 40 men’s testosterone generally declines at a rate of one percent each year. As a young male they enjoy the highest levels of testosterone from ages 21 to 24 years. By age 55 the testosterone level might be half of what they were when they were young. Some men think about having some of their sperm frozen for future use, just in case there are changes to their fertility.

6. Assess your overall health and ask your care provider. If your man suffers from a chronic medical condition and is on regular medications such as high blood pressure, epilepsy, diabetes and asthma etc. check with your doctor if these medications/over –the-counter-drugs are safe for fertility. Certain blood pressure, depression, anxiety, pain and chemotherapy medications can have an effect of sperm performance.

Lynn has written a book entitled, “Sperm Tales: An Informative Guide Through the Challenges of Infertility.” This is an A to Z guide through the fertility struggles that couples could face with advice and guidance, medical and otherwise. The book comes with a mascot sperm named Spanky, who tells little humorous comments at the end of chapters, which are actually comments that Lynn’s male patients made to her over the 12 years.

Sperm Tales can be found on on Amazon UK or US in hard copy or Kindle download.

RESOLVE January 7,2016

What to Expect ?

By Lynn M. Collins

Infertility has its own vernacular, or terminology, and I will help you understand some of the “infertility lingo”.

Some fertility programs are located in a large hospital setting and some in a more intimate clinic setting. The staff can consist of four to five Reproductive Endocrinologists (RE), Urologists, Nurses, Embryologists and professional counselors. Larger programs could have a larger staff. The clinic will have a laboratory, which may be called an Andrology Lab (Andrology is the study of the male reproductive organs). The lab consists of three to five medical technologists, depending upon the size of the clinic and whether or not it specializes in Andrology. The Andrology lab performs the blood tests and measures hormones; performs semen analysis and sperm washing for Intrauterine Insemination (IUI), and may possibly have a sperm bank. The clinic may have an In-Vitro Fertilization (IVF) lab or be affiliated with a hospital that has the lab. An IVF lab consists of many embryologists, which perform the intricate testing that goes along with IVF.

The Pivotal Role of Your Nurse

Depending on the program, a nurse is assigned to one or two specialists. The RE works together with you as a couple, and will order blood work and other diagnostic tests. But when it comes to physical exams the RE examines only the female partner. If the male has an abnormal semen analysis or any conditions that relate to the male reproductive system, he’ll be sent to an Urologist for an examination. The nurse that is assigned to a couple in a fertility program remains involved with the patients at every step, building communication and trusting relationships with the patients. Sandy Vance, nurse manager at Women’s Health Center has said, “Infertility has been compared to a terminal illness and when a woman has tried everything and cannot get pregnant, she begins to experience grief, shock, denial, isolation, depression and guilt. We work to get the woman to a place where she can understand what her status is.” (This is perhaps the only field in which nurses work more with the patients than the physicians.) Once you have the first consult with the specialist, the nurse then becomes the person with whom you will communicate the most on a monthly, weekly or even daily basis. Your nurse will give you a packet containing information on testing. It may also contain orders for your testing, instructions on giving injections, operational hours of the center, and who to call in an emergency. Please read this information and keep it in a safe spot at home. These nurses are on their phones most of the day, answering questions, encouraging, or giving instructions to their patients. One of the hardest calls they make to a patient is that her pregnancy test came out negative and it doesn’t get any easier. The best call is the one that delivers the news to the patient that her pregnancy is positive. Nurses are so excited and make that call first. In either case, as one of our nurses at our Women’s Health Center, Paula Ayers, has said, “The most gratifying compliment I can receive is when a woman does not achieve success in conceiving, despite all of our efforts, and she thanks us for the respect and supportive approach to her care.” One patient, who went through the program at the age of 40 and was diagnosed with old eggs, was able to get pregnant after her first IVF cycle. She said, “It may sound easy but until you are the one going through it you can’t appreciate the kindness of the nurses. Even on my lowest day, thinking this wasn’t going to happen, Sandy found something positive we could hold on to.” As you can see, nurses in a fertility program grow very attached to their patients and work very hard, with great compassion, to help patients navigate the ongoing ups-and-downs of an infertility program. I posed this question on Facebook to some fertility nurses: In a perfect world, what would make your day-today job easier when it comes to caring for your patients? Sandy Vance responded: “We all like it when patients ask questions, because it shows that they really want to understand their treatment. But it would be helpful if they would read all of the materials we send home with them. They really are helpful in explaining the process.”

How the Process Begins

The first phase will start you with one of the following Assisted Reproductive Technologies (ART) procedures and may progress to others depending on your success. These procedures include and not limited IUI and IVF. Beyond that, IVF can break down to include other techniques, such as, for example Intracytoplasmic Sperm Injection (ICSI). Below are a few brief descriptions of both IUI and IVF.

The IUI procedure is a simple procedure that takes little time and involves minimum discomfort. At the time of ovulation the sperm is collected and processed. The sperm is then placed in a catheter and is placed in the female’s uterus. It is very important that this procedure, also known as artificial insemination, occurs with ovulation. Using the over-the-counter ovulation kits can easily monitor the time of ovulation. The hormone Luteinizing Hormone (LH) is measured, noting when it spikes. This indicates ovulation has occurred and the female is at her most fertile time. The IUIs are performed seven days a week and take only about one hour. The males collect the specimens in the morning and drop it off at the lab. (Some centers prefer the males to collect the specimen at the center.) The lab performs a sperm wash to the specimen, wherein the non-motile sperm is separated from the motile sperm and other debris from the semen. The female partner returns to the center around 11:30 a.m. to 12:00 noon for IUI procedure. The washed specimen is placed in a catheter and is inserted through the cervix into the uterus where the specimen is released. The procedure is very similar to getting a pap smear. The patient relaxes in the exam room for about 10 to 15 minutes after the procedure and then she can resume her daily routine. The nurse instructs her to notify the nurse in two weeks if she has not gotten her menstrual cycle. At that time her blood will be drawn for a pregnancy test.

IVF is more involved than an IUI. An IUI is less invasive and the cost is much less. This procedure differs from an IUI because the eggs are removed from the female’s body. The female will take the gonadotropins follicle-stimulating hormone injections that will stimulate the ovaries to produce as many eggs as possible. The eggs will be removed surgically, which is called the retrieval, and then placed in a petri dish where your partner’s sperm will be washed and placed with your eggs. The dish is incubated and evaluated a few days later to see how many eggs fertilized. The female returns for an embryo transfer, which is where a certain number of embryos will be placed back or transferred into the uterus. The embryos will be placed in a catheter like the sperm for the IUI and placed in the uterus. You’ll return to the center in approximately 14 days after the procedure for a pregnancy blood test. The success rate for IVF is higher than IUI. Which procedure you start with depends on the results of your initial testing (for both of you), insurance coverage, and how aggressive you want to be, depending upon your success, or lack of success at other clinics. This will all be discussed with your medical team.

Lynn M. Collins is the author of Sperm Tales: An Informative Guide Through the Challenges of Infertility. Lynn draws on her experience as a laboratory supervisor for a leading national sperm bank and manager for a multi-million dollar infertility laboratory. In Sperm Tales, she offers compassion, humor, and clear step-by-step information about the numerous challenges–medical and otherwise–that attend the process of infertility treatment